In trauma patients, massive haemorrhage is the leading cause of mortality. Exsanguination accounts for more than 30% of mortality in trauma patients. The main part of the treatment of massive haemorrhage is to stop the bleeding. However, the development of trauma-induced coagulopathy (TIC) hampers this and exacerbates the bleeding. Kirsten Balvers focuses on some of the specific knowledge gaps in the field of diagnosis and treatment of TIC in severely injured trauma patients.